POLL: Did your insurance cover the vest?

[HelpCureCF]

We just found out that our insurance company is only going to pay $2500.00 toward The Vest (which costs $16,425.00) and that we are responsible for the rest. Just curious as to what everyone else's experience has been.
Thanks

 

[anonymous]

Yes, but I'm not sure how much my parents paid. It really reduced the price though.

 

[anonymous]

My son's vest was totally covered by our insurance. I know that there are ways to get assistance with getting it paid if your insurance company does not cover for it, however, as I did not have that experience I did not have to investigate into it. Others might have a few good suggestions though. Good luck!

Mom to 3 1/2 yr old son w/cf

 

[Jem]

Don't take no for an answer.  This is a necessary piece of
vital equipment for all Cfer's.  My Vest was paid for by my
insurance but only after an appeal was filed.  I needed to
prove my case as to the need and after some serious letter writing
and help from the Vest people on my behalf after about 5 months
payment was approved.  They didn't pay it in one lump sum
instead it was paid in monthly installments of about $1500 a month
until it was paid off.  The Vest people were very patient and
 helpful and worked with me to resolve this.  They have
people who work for them that specifically fight the insurance
company for you with your permission.  Good Luck with your
pursuit of payment.

 

[julie]

Yes, our insurance covered it, but if they hadn't the vest company told us that they would bill the ins. company for "rental" of the vest up the the maximum allowable each year. They would continue to do this until it was paid in full.

I would talk to the vest company about this, they are THE BEST about working with finances.

 

[NoExcuses]

Mine covers it at 95%.

 

[anonymous]

Coverage for "durable medical equipment" is all over the place: anywhere from nothing until you meet a deductible then some percentage up to 100% with no deductible. If you're in a position where you can change insurance companies, it might be worth looking into: I changed companies because my old one would pay 50% and my new one paid 100% (premiums and some other copays went up considerably, but not $8,000 worth in a year !)

 

[rcq925]

Our insurance company covered it as an out of network provider. Our insurance company made a deal with Hill-Rom on how much they would pay and left us with a $1,200 balance. Not bad. And Hill-Rom is going to work with us to pay $10 per month for 2 years ( we filled out financial paperwork and told them this was all we could afford) and after two years they will write off the remaining balance.

Hill-Rom is wonderful to work with and they even have a special person that deals with the insurance companies and on appeals. I would call them and see what they can do! Good luck!!

 

[anonymous]

If you don't have any luck with appealing your insurance company, I am trying to sell a brand new 2006 model 104 that has never been used. I'm trying to get $8000 CAN for it, which is considerably less than $16,000 US. Let me know if you are interested at debralamers@hotmail.com. Thanks

 

[JazzysMom]

MY insurance covered it 100%, but that was because of how the company billed it. The billed the insurance for the vest as tho it was a rental & when they got the total amount of the purchase price, they stopped billing! Except for deductables or maybe lifetime maximums, there should be a way around the allowed amount!

 

[anonymous]

Im assuming calebs was covered 100%... They sent it to us and i havent heard anything from hillrom since.. weve had it a little over a yr so i think if we had to pay we would have heard something by now..lol



Melissa mom to dylan 7 no cf and caleb 4wcf

 

[anonymous]

In Michigan we have a "Children with Special Health Care Needs" program, that helps you get things the insurance won't pay for. Our CF nurse had to fight for us to get it covered at first and then whatever my insurance didn't pay the Childrens insurance picked up!

 

[ladybug]

Mine was also paid 100% because it was considered a rental. You never actually own the vest unless you pay the amount out of your own pocket. Otherwise, the insurance co.'s and hill-rom still own it (that's my understanging)... I you're in the U.S., it really should be covered.

 

[Giggles]

Yes. I ordered it after I had reached my out of pocket, so it got covered at 100% Praise the Lord! Good luck with the expense!!!



Jennifer 34 years old with Cf and CFRD

 

[anonymous]

My son's vest was 100% covered but only after we appealed the initial denial.

Nicole

 

[cfmomma]

I don't know yet. My son got fitted for the vest last week @ his clinic visit and I should find out soon what insurance will cover. I'm terrified!

 

[JennifersHope]

The Vest Company really did everything for me, All I had to do was give them the prescription for the vest and they took care of the rest.

I know it was considered durable medical equipment and I didn't have to pay a penny for it, but the insurance company ended up gettting paid a few thousand a month as rental equipment, I think mine is close to being paid off now since it has been a while since the vest company has called to check in with me.

I have had nothing but really great experiences with the vest ppl, they were great.

I would not take no for answer on the vest I would insist

Jennifer

 

[Allisa35]

I was very fortunate in that our clinic was picked as a "trial clinic". They gave us the vest at no cost to us (my sister also got one). They had a few stipulations. You had to supply them with any info they requested about your insurance company and they would call you every so often to get the number off the bottom of the machine (I think this was to keep track of how often it was used). That was several years ago. I was very good about using it initially, but have slacked off the last couple of years. I know they have better models now than this one. This one is very uncomfortable for me (it is really tight on my chest and it hurts). I do know that my insurance company denied the claim. I think the vest company did appeal but to no avail. But at that time, the vest was a new thing. Maybe it is something that they would cover now, who knows.

 

[anonymous]

Ours was covered 100%. We originally thought it would be covered only 80% but our case manager got it covered 100%. If you don't have a case manager through your insurance company than I suggest you try that route to see if he/she can get you more coverage. I believe case management is a service that all insurance companies have to provide for free (someone correct me if I am wrong). They can be very helpful in situations like our kids have to deal with.

Best Wishes!